From the Archives: Attorney General Ken Cuccinelli says Obamacare decision is 'a win for liberty'

Attorney General Ken Cuccinelli says Obamacare decision is 'a win for liberty'
June 28, 2012 11:30 AM MST

In a press conference today, Virginia Attorney General Ken Cuccinelli said that the Supreme Court’s health-care decision was a “victory for individual liberty” and that his initial reaction to the ruling was more negative than it ought to have been.

Speaking to reporters in Richmond and via telephone conference call, Cuccinelli called the ruling “a win for liberty” and explained that for the first time in 85 years, the Supreme Court had set “an outer limit” on the expansion of federal authority through the Commerce Clause.

He said that by its 5-4 ruling on the limits of the Commerce Clause, the Court had put in place a “critically important containment of federal power” and that in the parts of the ruling dealing with Medicaid, the justices had for the first time since the New Deal said that Congress has limited power to compel states to act through its spending authority.

Politics and legislation
Moreover, Cuccinelli argued, by defining the individual mandate as a “tax,” as Chief Justice Roberts did in his majority opinion, the Court opened up political challenges to the law because Congress’s taxing authority is the most accountable and sensitive of its powers to popular will.

By calling it a tax, he said, the Court (specifically the Chief Justice) removes the political cover for those legislators who claimed not to have voted for a tax increase. They can no longer go back to their home districts and say they did not vote for a tax, he said, and thus they will be subject to the judgment of voters on Election Day.

Given that, Cuccinelli predicted that, with the impending elections this November, the ruling will show the critical role that voters play in “ensuring that their liberties are preserved.”

‘Bipartisan failure’
As a policy matter, Cuccinelli said, health-care legislation has been “a bipartisan failure” and that the Affordable Care Act is such a “bad policy” that even the people who supported it are backing away from it, as a constitutional matter, “individual liberty has been substantially preserved in this case.”

He also noted that, apart from the aspects of the law addressed in the decisions delivered by the Court today, there are still matters about the ACA that continue to be litigated. He gave as an example the lawsuit filed by the Catholic bishops with regard to contraceptives.

Federalism preserved
Cuccinelli said that the justices came to their decision in an “unlikely way,” but that “if there had been five votes to compel us into commerce, federalism would have been dead,” pointing out that Justice Ruth Bader Ginsburg, in her dissent on the Commerce Clause part of the ruling, claimed that the “Commerce Clause power is plenary,” that is, unlimited.

Wrapping up, the Virginia Attorney General said that upon reflection, his analysis of the Supreme Court’s health-care ruling is more muted than his initial reaction was, and that “by and large” the decision preserved individual liberty.


Publisher's note: This article was originally published on Examiner.com on June 28, 2012. The Examiner.com publishing platform was discontinued July 1, 2016, and its web site went dark on or about July 10, 2016.  I am republishing this piece in an effort to preserve it and all my other contributions to Examiner.com since April 6, 2010. It is reposted here without most of the internal links that were in the original.

From the Archives: Virginia Governor Bob McDonnell writes to HHS Secretary about Obamacare burdens

Virginia Governor Bob McDonnell writes to HHS Secretary about Obamacare burdens
February 7, 2011 12:49 PM MST

Arguing that the future of the Patient Protection and Affordable Care Act (PPACA, known colloquially as “Obamacare”) has resulted in uncertainty for consumers as well as providers of health care, Virginia Governor Bob McDonnell has sent a letter to Health and Human Services Secretary Kathleen Sebelius. In his letter, he asks for clarification of several provisions of the PPACA even while insisting that the law is both unconstitutional and bad public policy.


‘Fundamentally flawed’
In his letter, dated February 7, McDonnell says the law “is fundamentally flawed with unconstitutional and inflexible provisions, and should be repealed.” He also predicts that the PPACA will “ultimately be struck down by the U.S. Supreme Court.”

Federal judges in both Virginia and Florida have ruled that the law, in particular the so-called “individual mandate” that penalizes people who do not purchase health insurance, is unconstitutional. In the Florida case, the judge ruled that, in the absence of a clear severability clause, the entire law fails to meet the test of constitutionality.

While the judicial challenges to Obamacare are running their course, McDonnell argues in his letter to Sebelius, “states are faced with considerable uncertainty.” In this atmosphere of uncertainty, state government will still have to make decisions about health benefits exchanges and other aspects of PPACA, decisions that are more difficult because state budgets are in a precarious position right now.

Six issues
McDonnell lists six specific issues that require clarification by the federal government to alleviate the uncertainty and assure that the health-care system will not be disrupted between now and 2013, when the federal law is scheduled to take full effect (in the absence of a Supreme Court ruling that it is unconstitutional or the decision to repeal the law by Congress and the President).

Among the six items McDonnell asks for are “waivers to the costly mandates” of the federal health-care law and permission for states to set their own eligibility rules; waivers of provisions of the law that hinder health savings accounts (or HSAs) that offer free-market solutions to problems in the health-care system; and the commissioning of an objective study that will show “how many people will end up in the exchanges and on Medicaid in every state as a result of the legislation.”

In his closing paragraph, McDonnell states that, if Secretary Sebelius agrees to his suggestions, “governors might be able to provide coverage to our citizens without destroying our budgets or perpetuating and magnifying the most costly aspects of our health care system.”

In addition to sending the letter to Sebelius, McDonnell also provided copies to the entire Virginia congressional delegation and to Indiana Governor Mitch Daniels, who has been widely rumored to be a potential candidate for the Republican presidential nomination in 2012.


Publisher's note: This article was originally published on Examiner.com on February 7, 2011. The Examiner.com publishing platform was discontinued July 1, 2016, and its web site went dark on or about July 10, 2016.  I am republishing this piece in an effort to preserve it and all my other contributions to Examiner.com since April 6, 2010. It is reposted here without most of the internal links that were in the original.

From the Archives: Gay and libertarian GOP groups critique SCOTUS Obamacare ruling

Gay and libertarian GOP groups critique SCOTUS Obamacare ruling
June 28, 2012 1:59 PM MST

While politicians around the country have offered their views on the U.S. Supreme Court’s decision today regarding the Affordable Care Act (colloquially known as “Obamacare”), some discrete interest groups within the Republican party have added their voices to the mix.

Two groups with similar initials – LCR and RLC – have weighed in on the debate about the meaning and impact of the Court’s ruling.

Log Cabin Republicans (LCR), which calls itself the largest organization of gay and lesbian activists within the GOP, raised attention to the discriminatory provisions of the health-care laws.

Not ‘carved in stone’
Christian Berle, LCR’s deputy executive director, said in a press statement that Log Cabin Republicans "have not forgotten that Democrats in Congress stripped provisions protecting LGBT families out of healthcare reform when it was passed. We remain committed to ending the Internal Revenue Service’s discriminatory treatment of employer-provided healthcare for domestic partners. While the Court may have found Obamacare to be constitutional, that does not mean it has been carved in stone. Now is the time to go back to the drawing board and institute reforms that work for all Americans.”

Berle also criticized the individual mandate, which was upheld as constitutional based upon its status as a tax.

“By upholding even the most intrusive provision of Obamacare, the individual mandate, the court has enabled Washington’s addiction to big government and coercive taxes,” Berle said, explaining that “the individual mandate forced through Congress was an unprecedented expansion of federal power in blatant disregard of the will of the American people.”

The Republican Liberty Caucus (RLC), an organization of libertarian and classical liberal activists within the GOP, touted its endorsed candidates as the remedy for Obamacare.

‘Unreasonable taxation’

A statement emailed to members and the news media by RLC chair Dave Nalle argued that “while Obamacare may technically be Constitutional, because the 16th Amendment opens the door to all sorts of unreasonable taxation, that does not mean that it is good policy. Raising taxes enormously on every citizen, either directly in the form of penalties or indirectly in the form of mandated health insurance and inflated prices, is outrageous in a time of high unemployment and economic uncertainty.”

The RLC statement explained:

“As fewer and fewer people pay taxes at all, placing an even greater burden on the productive segment of the population is unconscionable. Even worse, this is just the first step. As insurance prices rise the call will come for more interference by government and we will slide into the complete control of the healthcare system by unaccountable bureaucrats, an end to individual choice and a rapid decline in quality of service.”

Saying that today’s ruling provides Republicans with “a winning issue” and “a rallying cry,” the RLC pointed to its candidates as supporters of repeal of the unpopular health-care law.

“Candidates like Ted Cruz in Texas and Barry Hinckley in Rhode Island are poised to join our prior endorsees like Rand Paul and Mike Lee in creating a powerful voting block in the Senate which will never compromise when liberty is threatened,” said the RLC statement.

“In the House those same values which are being championed today by Ron Paul and Justin Amash will be carried forward with reinforcements like Thomas Massie in Kentucky, Lauren Stephens in Wisconsin, Kerry Bentivolio in Michigan, Jessica Puente Bradshaw in Texas and scores of others,” the RLC continued. “With their guidance Congress will reassert its authority over the federal bureaucracy and demand accountability from the executive branch.”

Earlier in the day, an independent gay conservative group, GOProud, also issued a statement severely critical of the Supreme Court’s health-care decision.


Publisher's note: This article is part of a series to mark June as Gay Pride Month. It was originally published on Examiner.com on June 28, 2012. The Examiner.com publishing platform was discontinued July 1, 2016, and its web site went dark on or about July 10, 2016.  I am republishing this piece in an effort to preserve it and all my other contributions to Examiner.com since April 6, 2010. It is reposted here without most of the internal links that were in the original.

From the Archives: GOP Senate candidate Ed Gillespie sees 'energized, excited' party activists

Publisher's note: This article was originally published on Examiner.com on June 5, 2014. The Examiner.com publishing platform was discontinued July 1, 2016, and its web site was scheduled to go dark on or about July 10, 2016.  I am republishing this piece in an effort to preserve it and all my other contributions to Examiner.com since April 6, 2010. It is reposted here without most of the internal links that were in the original.

GOP Senate candidate Ed Gillespie sees 'energized, excited' party activists

Former national and state Republican chairman Ed Gillespie is one of four candidates seeking the GOP nomination for the U.S. Senate from Virginia at a state party convention in Roanoke on Saturday, June 7.

The winner of the nomination contest – either Gillespie, Tony DeTora, Shak Hill, or Chuck Moss – will go on to face incumbent Senator Mark Warner (D-Alexandria) in November. Libertarian nominee Robert Sarvis may also be on the ballot, pending his meeting the petition requirements by the filing deadline of Tuesday, June 10.

Gillespie spoke to the Charlottesville Libertarian Examiner on the sidelines of the Fifth Congressional District GOP convention at Hampden-Sydney College on May 17. He expressed his views about health care reform, Warner's vulnerabilities, his appeal to libertarian-leaning voters, and whether he will debate any ballot-qualified candidate during the election campaign.

Party unity
Although the party canvass and convention process so far in 2014 has been fractious, Gillespie believes that “unity is possible.”

Republicans, he said, are “energized, they're excited.”

Gillespie pointed to “massive turnout at our district conventions and people getting energized and excited and coming into the process” as being “a good thing for us.”

With regard to the disputatious nature of the convention process, he said that “a little friction, a little tension here and there, that's a sign of a growing party. I would rather have the growing pains of a growing party than no pains of a shrinking party.”

Libertarian voters
Asked how he can earn the votes of libertarian-leaning Virginians in November, Gillespie asserted that “we have a lot of common ground with our libertarian-leaning members of our party and libertarian-leaning members of the electorate obviously. We are in favor of less government intrusion in our lives, we're in favor of lower taxes, we're in favor of stopping reckless spending, we want to get Obamacare out of making decisions about what our health insurance can be and who our doctors can be.”

He noted his view that, “if you believe in our constitutional principles of limited government and personal freedom, then anyone with a strong libertarian leaning needs to vote for our nominee come November.”

Gillespie would not, however, commit to debating any ballot-qualified candidate during the campaign. “I'd debate Mark Warner happily,” he said, but with regard to Robert Sarvis or any other possible Senate candidate, he demurred.

“I don't know. We'd have to look at that. Obviously, my focus is on Mark Warner,” Gillespie said.

Job killer
Warner's vulnerabilities include “his job-killing policies, his voting with President Obama and Harry Reid 97 percent of the time,” the GOP hopeful said.

Warner, he continued, “didn't just vote for Obamacare, which kills jobs. He voted against an amendment to repeal the medical device tax --165,000 jobs right there. He's for cap-and-trade or a carbon tax. A cap-and-trade regime would cost Virginians alone 66,000 jobs. He has voted job killing policy after job-killing policy. The fact is, his policies have resulted in lost jobs, lower take-home pay, skyrocketing health-care costs, and higher energy prices.”

In contrast, he asserted, Republican policies, “based on free markets and free people, would result in more job creation and higher take-home pay, and lower health-care costs, and bringing down energy prices.”

Gillespie also summarized his views on how to repeal and replace the Affordable Care Act, sometimes called Obamacare.

Repeal and replace
“We need to repeal it because it's designed to get us to a single-payer system over time. We've got to repeal it and replace it with market-oriented reforms,” he said.

“I'm looking at a positive alternative to put forward for the people of Virginia. Some of the things I've been talking to people about are allowing for insurers to market across state lines. There's an artificial barrier there that doesn't exist in the auto market or the life insurance market. It shouldn't exist in the health insurance market.”

Gillespie also suggested a policy that would give “equal tax treatment for the employer or the employee, giving the employee more power in that regard. That would also help, so when you change jobs you wouldn't be at risk of losing insurance for a pre-existing condition.”

He pointed out the need for reform of medical malpractice laws, “which are driving up health care costs by virtue of defensive medicine practices or exorbitant awards. People need to be protected in our judicial process in the event of hospital error or doctor's error but we can do that without driving up the cost of health care.”

Gillespie also noted that medical savings accounts “hve been gutted by this administration” but should be “beefed up” instead.

He concluded his discussion of health-care policies by saying that he is “looking forward to talking about a positive alternative [to] replace Obamacare. People want to know what we're for as well as what we're against.”

He also expressed confidence about his chances of winning the nomination in Roanoke.

“I am very excited about the convention. I believe we're going to have a unifying convention in Roanoke; I think we can bring our party together. I'm very optimistic about how that's going and like our delegate count a lot.”

Saying he will support the eventual nominee “110 percent,” but adding that “ I'm hoping it's going to be me,” Gillespie concluded that “we have real momentum and a chance to unify our party for a big win in November.”

An audio version of this interview with Senate candidate Ed Gillespie is available on Bearing Drift's podcast, “The Score.”

SUGGESTED LINKS

GOP Senate candidate Chuck Moss emphasizes technology issues, outsider status
GOP Senate hopeful Tony DeTora favors marijuana law reform, opposes Mark Warner
'Proselytizing for freedom,' Robert Sarvis bids for U.S. Senate in Virginia
Virginia Senator Mark Warner discusses budget issues, independent voters
GOP Senate candidate Shak Hill thinks government is 'overreaching'

Original URL:  http://www.examiner.com/article/gop-senate-candidate-ed-gillespie-sees-energized-excited-party-activists

Will Medicaid expansion actually make poor people healthier?

Members of the General Assembly who oppose Governor Terry McAuliffe's proposals to expand Medicaid in Virginia under the terms of the Affordable Care Act (ACA, also called "Obamacare") may find some intellectual ammunition to bolster their case in a study published on March 24 by the Mercatus Center at George Mason University.

The Economics of Medicaid: Assessing the Costs and Consequences, edited by Jason J. Fichtner, contains a lot of wonkish economic analysis, such as Nina Owcharenko's chapter on "the state side of the budget equation," which shows the astronomical growth in Medicaid spending and enrollment over the past two decades (see the graph to the upper left), but the most significant findings may be in the book's last chapter, by Robert F. Graboyes and titled "Medicaid and Health."

Graboyes relies on previous studies in several states and on reports from the Government Accountability Office and other federal agencies to demonstrate that people who rely on Medicaid for health insurance not only have worse health comes than those who have other types of insurance, but worse than people with no insurance at all.

What's more, rather than taking patients out of emergency rooms and putting them in doctors' offices for routine health care, expansion of Medicaid coverage tends to increase emergency room visits by Medicaid recipients.

I'll let Graboyes -- a senior research fellow who was formerly an economist with Chase Manhattan Bank and the Federal Reserve Bank of Richmond, as well as a faculty member at the University of Richmond -- tell it in his own words (end notes omitted).

Pages 175-76:

A Mercatus publication I authored in 2013 stated the following: “An ideal health care system will provide better health to more peo­ple at lower cost on a continuous basis.” By this standard, Medicaid is an abject failure. For lower-income Americans, Medicaid yields poor coverage, poor care, and poor medical outcomes. While prom­ising coverage far beyond the program’s original scope, it fails to enroll millions of people who are among its intended population and who are eligible for enrollment. The data suggest that Medicaid does surprisingly little to improve its recipients’ health and in some ways may even harm them indirectly. It is a pennywise-and-pound-foolish program that, paradoxically, sends costs soaring by underpaying pro­viders. And the coverage, care, and cost elements show little or no improvement over time.

Pages 181-82:

In 2010, the University of Virginia conducted a large-scale study that suggested that an individual without insurance has better health outcomes than an individual on Medicaid.47 Even after adjusting for risk factors, Medicaid patients had higher in-hospital mortality, longer hospital stays, and higher costs—compared with the uninsured, those on Medicare, and those on private insurance plans.48 A University of Pennsylvania study examined data on patients receiving surgery for colorectal cancer; Medicaid patients had higher mortality and surgical complications than uninsured patients.49 A 2011 Johns Hopkins study found that “Medicare and Medicaid patients have worse survival after [lung transplantation] compared with private insurance/self-paying patients.”

Perhaps the most damning of all the recent studies is the Oregon Experiment. This was a rare example of a large-scale, fully ran­domized experiment in health care. In 2008, Oregon expanded its Medicaid program. Approximately 90,000 people applied for 30,000 newly available slots, and the state used a lottery to choose who got in and who did not. Afterward, the state tracked the health of 6,387 adults who were chosen and 5,842 who were not. From a standpoint of physical health, the results were devastating: “This randomized, controlled study showed that Medicaid coverage generated no sig­nificant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain.” Supporters of Medicaid point to positives that follow the word “but” in the preceding sentence.

Page 177:

Rapid expansion of Medicaid, as envisioned under the ACA, also has the potential to touch off a cycle of expansion, financial over­load, and mass cancellations of coverage. The best example of such a process is the TennCare disaster that began in 1994 in Tennessee. The state sought to convert Medicaid to managed care, assuming this would lead to enough savings (from efficiency gains) to cover children and the uninsured. In less than a decade, however, enroll­ ment swelled far beyond what had been predicted, and the savings proved elusive. The expansion threatened the state government with bankruptcy and, by 2006, the program was forced to cancel cover­age for approximately 200,000 Tennesseans. A high-profile study of Oregon’s Medicaid expansion provides powerful new evidence that expansion increases rather than decreases the use of emergency services; putting it another way, one of the principal arguments in favor of expansion now appears illusory [emphasis added].

The whole book, which is also available in a Kindle edition, is chock-a-block with nuggets like these. Even legislators who don't read bills before they vote on them should read this book.

Cross-posted from Bearing Drift (April 12, 2014).

@rick_sincere | facebook.com/ricksincere

Today Is Repeal Day - Let's Celebrate!

Today, across the country, Americans are celebrating "Repeal Day." As David Boaz of the Cato Institute put it, "Today is a great day for freedom."

What's the celebration about? We are commemorating the 80th anniversary of the 21st Amendment, which was ratified on December 5, 1933, and took effect ten days later (coinciding with Bill of Rights Day). Ratification was confirmed by a vote of the Utah legislature to repeal the 18th Amendment that prohibited the manufacture, distribution, and sale of alcoholic beverages within the boundaries of the United States.

While it would be easy to attribute the celebration to nothing more than the desire of Americans to imbibe a shot and a beer without bribing a police officer or paying a mobster, the repeal of the Prohibition amendment represents something far more fundamental: It means that, despite Ronald Reagan's quip that "the nearest thing to eternal life we will ever see on this earth is a government program," it is indeed possible to end programs that fail miserably, are counterproductive, increase the size and scope of government, and intrude in the private lives of citizens.

In other words, the 21st Amendment should offer a lesson for everyone who wants to repeal Obamacare (or, for that matter, marijuana prohibition and NSA domestic spying).

Although recent history may give more reason for pessimism, it is not impossible to reverse a bad government program. The effort may take hard work, extend over a long time (Prohibition lasted almost 14 years and its effects are still with us -- such as Virginia's socialist liquor monopoly), and encounter setbacks, but success can happen.

With that in mind, to quote Franklin D. Roosevelt, "What America needs now is a drink!" Toast now; legislate later.

(Cross-posted from Bearing Drift)